Although many drugs destroy Entamoeba histolytica within the colonic lumen, the number of tissue
amebicides used to treat invasive
amebiasis is still relatively limited.
Metronidazole (MTZ), which is the
drug of choice for invasive
amebiasis, and other
nitroimidazoles have greatly simplified the
chemotherapy of this disease. However, eradication of E. histolytica
infection after completion of MTZ
therapy requires additional treatment with
luminal amebicides, such as
paramomycin. After decades of the introduction of MTZ and other
nitroimidazoles in the
therapy of
amebiasis, there have been few innovations in treating amebic
infections. Meanwhile,
amebiasis remains among the leading causes of morbidity and mortality in the contemporary world. The toxic effects of MTZ and recent failures in the treatment of several intestinal protozoan parasites, has led to a search for other amebicidal drugs. A recent advance is the demonstration of the effect of
nitazoxanide, which has broad spectrum of
antiparasitic activity, against E. histolytica. This compound could be the key in the
therapy of
amebiasis by its action against both
luminal and invasive parasite forms. However, the design of an effective
vaccine against the
infection is still being desirable. Work is underway to develop a
vaccine and recent experimental studies are promising. The aim of this review is to examine and discuss the most important aspects of current antiamebic
pharmacotherapy and the prospects for development of new drugs and a
vaccine.